While there are many forms of dementia, it’s a progressive illness that usually causes significant decline in a person's mental abilities or 'cognitive function' – such as our capacity for memory, thinking and reasoning.
Over time the way someone with dementia communicates will change, as they struggle to remember conversations or what they have done recently. This is because the hippocampus in the brain which takes on new information becomes damaged. So, this means if you have a family member or know a person with dementia, they may forget conversations or plans they’ve arranged.
It can become really challenging to know how to best talk to someone with dementia, so we’ve put together this guide to help you.
As the illness progresses, you might notice that your family member struggles to start or keep a conversation going. So, you could help by starting a discussion. Sometimes the responses will be delayed so you may need to give the person plenty of time to respond to you.
If there are a group of people chatting together, you could help to encourage them to join in by asking a question related to what you’re talking about.
By speaking with shorter sentences, with fewer long words and by taking your time to speak, they’re more likely to be able to follow the conversation.
Using body language
We communicate through body language as well as our words. And you can communicate in lots of different ways through non-verbal communication. For example, if you give eye contact when you’re speaking, your loved one will see you’re communicating with them, even if they don’t understand all of the words. Using visual cues like facial expressions to show how you’re feeling, especially for someone who is struggling to speak is also helpful.
Holding your loved one’s hand while they speak can also help them to feel more at ease. Or by smiling when they speak to you can show that you’re engaged in what they’re saying.
What to do if someone is struggling to speak
People with dementia may find it hard to speak as the condition progresses. It can be frustrating for your loved one when they cannot find the right ways to communicate with you. So, it’s important to positively encourage them to say whatever they can. This will help them feel less worried about speaking and will encourage them to communicate with you.
It is also important to remain calm as they might need extra time to respond or to find the right words they want to say.
You could also try rephrasing questions if your loved one doesn’t seem to understand the question. Or you could try offering simple options for them, rather than leaving a question open to interpretation with lots of different ways to answer it.
If they respond to your question, but don’t give you a clear answer, you could try and encourage them to say more about what you’re discussing. This could lead to your question being answered.
As short-term memory is affected by dementia, helping your loved one to set up a routine they keep to every week can help them remember what they do each day. So, for example, you could arrange to call or visit them every Wednesday evening.
If your loved one has dementia, as their condition progresses, you may need to listen more attentively than before so you can understand them.
This is sometimes known as active listening and there are certain techniques you can try which will help such as:
- Give your full attention when they’re speaking.
- Always use eye contact when they’re talking.
- Turn off background noise, such as the TV or radio so you can concentrate on their words.
- If you’re unsure of what they’re trying to tell you, you could check with them what you think they mean. If you have misunderstood them, this gives them the opportunity to correct you.
As well as these general practical tips on how to talk to someone with dementia, as the dementia progresses so will their ability to communicate. So, we’ve put together these tips on how to communicate during the different stages of dementia.
How to talk in the early stage
During this stage, you’ll probably notice your loved one can still engage in conversation and socialise with their friends. But you might notice that they sometimes struggle to find the right words or tell you a story more than once.
It’s important to be patient and not to interrupt the conversation – even if you think you know what your loved one is trying to say, as with some time and space, they should be able to communicate what they want to say.
If you’ve noticed your loved one no longer seems happy doing everything they used to do, check with them what they feel comfortable doing and help them make changes to their routine if they would like help.
Keep involving your loved one in the conversation, rather than speaking to another family member or caregiver on their behalf.
Talking in the middle stage
This stage usually lasts for the longest amount of time. During the middle stage, you might notice you need to adapt how you were talking to your loved one in the early stage as they start to struggle to communicate with you.
At this stage, you may find it’s helpful to keep good eye contact while you speak and speak clearly and slowly. Group conversations might now be too challenging, so it will probably be easier to talk to your loved one on your own somewhere quiet.
If you ask your loved one any questions, only ask one at a time and wait for them to answer before asking another one, as this can be confusing for them to answer. And if you give any instructions, you could try explaining one at a time or writing them down and going through them together.
Your loved one might get confused and frustrated trying to communicate, so it’s important to avoid arguing maintaining a calm tone of voice if you can. Or you might find that changing the conversation or what you were both doing, could help calm them down.
Music & Art Therapy for communication
Music can be a powerful tool. Studies have shown music may reduce agitation and improve behavioural issues that are common in the middle-stages of the disease. Even in the late stages of Alzheimer's, a person may be able to tap a beat or sing lyrics to a childhood song. Music provides a way to connect, even after verbal communication has become challenging.
Art projects can create a sense of accomplishment and purpose. They can provide a person with dementia, as well as their carers, an opportunity for self-expression.
Talking in the late stage
Once your loved one reaches the late stage of dementia, you may find there is very little verbal communication and they are now receiving full-time dementia care. So, during this stage you’ll find using non-verbal cues such as facial expressions like smiling, eye contact and touch are helpful here.
You can try to encourage non-verbal communication with your loved one by smiling, pointing or by making gestures. Keeping them company is also important, even if you can no longer talk to one another anymore.
While there are some common difficulties when it comes to communicating with someone who has dementia, everyone will experience it uniquely. We hope you may find some of our suggestions for how to talk to someone with dementia helpful and we’d love to hear if you have any tips that worked with your loved one.
If you would like to find out how we support dementia and Alzheimer’s disease with in-home care visit our service page.
Or to find out more about dementia support available visit the Alzheimer’s Association.